Care Management Operations & Programs Lead

Neighborhood Health Plan of Rhode Island; Smithfield (RI); On-site; USD 85,000 - 120,000; Full time

Job summary

Neighborhood Health Plan of Rhode Island is seeking a senior leader to oversee the Care Management area within Medical Management. You will guide program development, staff supervision, and the operationalization of new CM programs while ensuring regulatory and contractual requirements are met.

The role includes directing work plans, monitoring outcomes, and delivering regular clinical reports. You will lead continuous improvement, collaborate with medical leadership, and serve as a CM subject

Qualifications

• Active, unrestricted Rhode Island Nursing or LICSW license in good standing ( RI license application within 24 hours of offer).
• 5+ years’ experience in clinical, managed care and/or operational management.
• 5+ years supervisory experience.
• Strong collaboration, interpersonal and leadership skills.
• Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Ability to work extended hours including evenings, nights and weekends.

Responsibilities

• Develops, executes and evaluates work plans for area of responsibility.
• Monitors, evaluates, and reports on CM program outcomes.
• Supervises staff and provides coaching and performance feedback.
• Collaborates with Chief Medical Officer and Medical Director on CM programs.
• Develops and maintains CM documentation standards and policies.
• Participates in budget development and operational improvement initiatives.
• Represents CM programs with state and community partners.

Skills

Leadership

Analytical skills

Communication

Collaboration

MS Office

Education

Bachelor’s degree in health-related field

Associate degree in Nursing with 7+ years supervisory

Master’s degree (preferred)

Tools

Microsoft Office

Job description

Neighborhood Health Plan of Rhode Island is seeking a senior leader to oversee the Care Management area within Medical Management. You will guide program development, staff supervision, and the operationalization of new CM programs while ensuring regulatory and contractual requirements are met.

The role includes directing work plans, monitoring outcomes, and delivering regular clinical reports. You will lead continuous improvement, collaborate with medical leadership, and serve as a CM subject